Best Health & Dental Insurance Plans in Ontario

The best health and dental insurance plan in Ontario is the one that matches what your household actually spends money on. Someone on two daily prescriptions needs strong drug coverage. A family with three kids needs dental with good preventive care and no long waits. A healthy 30-year-old freelancer mostly needs a safety net that doesn’t cost much.

Because those needs differ so much, no one insurer or plan wins across the board, and we’d be suspicious of any list that says otherwise. What this guide gives you instead is a clear picture of how Ontario’s individual plans are built, which insurers sell them, what each tier typically includes, and a decision framework for picking the right one for you.

It’s written for people buying their own coverage: self-employed and contract workers, early retirees, new graduates, people between jobs, and anyone whose employer plan is thin enough that topping it up makes sense.

What OHIP leaves out (and why these plans exist)

Ontario’s public plan covers medically necessary doctor and hospital care. It does not cover most prescription drugs for adults under 65, dental care, vision care for most adults, or paramedical services such as physiotherapy, massage, chiropractic and psychology. Ambulance rides carry a co-payment, and out-of-country emergencies are barely covered at all.

Individual health and dental plans exist to cover exactly those gaps. If you want the full list, we’ve written it up in what OHIP does not cover.

Who sells individual health and dental plans in Ontario

Most of Canada’s major insurers have an individual health and dental product line for people without group coverage. In general terms, the field includes:

• Manulife, with tiered plans and a separate conversion product for people leaving group plans.
• Sun Life, with tiered personal health plans and a guaranteed-acceptance option.
• GreenShield, with a range of tiers and a strong focus on drug and dental benefits.
• Blue Cross (Ontario Blue Cross), with tiered plans and guaranteed-acceptance options.
• Canada Life, with plans built around choosing health and dental modules.
• GMS (Group Medical Services), with plans that tend to be straightforward and competitively priced.
• Desjardins, Equitable and others in certain segments or through specific channels.

Each of these designs its plans a little differently: some reimburse drugs at 80% with an annual maximum, some at 70% with a higher maximum, some cap dental at a lower figure but skip the waiting period. That’s why two plans at the same monthly premium can pay out very differently. As an independent brokerage, Hayes can place business with these insurers, so you can compare them through us rather than one at a time.

Plan tiers: what “basic”, “enhanced” and “premium” usually mean

Naming varies by insurer, but Ontario individual plans almost always come in three or four tiers. Here is what each tier typically includes. Every figure is a general pattern, not a specific insurer’s plan.

Feature	Basic tier	Enhanced tier	Premium tier
Prescription drugs	70–80% to a low annual max (often a few hundred to about $1,000)	80% to a higher max (often several thousand)	80–100% to a high or unlimited max
Dental: preventive and basic	70–80%, modest annual max	80%, higher annual max	80–100%, highest annual max
Dental: major (crowns, bridges, dentures)	Usually not covered	Sometimes covered at 50% after a wait	Covered at 50%, often after 12+ months
Orthodontics	Not covered	Rarely	Sometimes, with a lifetime max
Paramedical (physio, massage, psychology, etc.)	Low per-practitioner caps	Moderate caps	Higher caps
Vision	Small allowance or none	Modest allowance every 2 years	Larger allowance
Travel emergency medical	Sometimes included, short trips	Usually included	Included, longer trip limits
Health questions	Often guaranteed-issue	Sometimes underwritten	Usually underwritten
Indicative monthly premium, single adult	roughly $60–$90	roughly $90–$140	roughly $140–$220+

The premium column is illustrative for Ontario in 2026 and varies with age, deductible and insurer. Families and couples cost more, though usually less than two or three separate singles.

The six things to compare before you decide

When we put plans side by side for clients, these are the lines that decide it.

1. Drug coverage: percentage and annual maximum. The percentage tells you what you pay per prescription; the maximum tells you where the plan stops. If you take a medication costing $300 a month, a $1,000 annual maximum runs out by April. Check whether the plan uses a managed formulary, and whether it caps dispensing fees. Our prescription drug coverage in Ontario explainer goes deeper.
2. Dental: what’s covered and when. Preventive and basic dental usually starts at once or after a short wait. Major restorative typically carries a waiting period of a year or more on individual plans. If you already know a crown is coming, be realistic: the plan won’t pay for it next month.
3. Waiting periods and pre-existing conditions. Guaranteed-issue plans often exclude pre-existing conditions for a set period or cap what they pay. Underwritten plans can exclude a specific condition permanently or decline. Read the exclusions section before the benefits section.
4. Paramedical caps and eligible practitioners. If you see a physiotherapist or a psychologist regularly, the per-practitioner cap and whether your practitioner’s registration qualifies matter more than the headline percentage. For therapy specifically, see does insurance cover mental health in Canada.
5. Deductibles and co-payments. Some plans use an annual deductible; some use per-prescription co-pays. A small deductible in exchange for a lower premium is often a fair trade for a healthy household.
6. Price stability. Individual plan premiums rise with age bands and with the insurer’s claims experience. Ask how the plan has been repriced in recent years and whether coverage is guaranteed renewable.

Which plan is best for you: a decision guide

Here’s how we usually think about it by profile.

Healthy single adult, no regular prescriptions. A basic or enhanced tier, guaranteed-issue, from a competitively priced insurer. You’re buying protection against the unexpected prescription and a couple of dental cleanings. Don’t overpay for major dental you’re unlikely to use in the next few years, but consider a tier one step up if you might want major dental later, since the waiting clock starts when you buy.

Person with ongoing prescriptions. Choose the tier by drug maximum first, everything else second. If your medication costs are high and stable, an enhanced or premium underwritten plan may still accept you, and a conversion plan is the fallback if you’re within 60 days of leaving a group plan. Ontario’s Trillium Drug Program can also cap your out-of-pocket drug costs at a share of household income; see our OHIP+ vs. private drug coverage guide for how public and private drug coverage fit together.

Family with children. Dental and drugs dominate. Look for a plan with strong preventive dental, reasonable per-person maximums, and orthodontic coverage only if you truly expect to use it (it’s often not worth the premium). Children under 25 with no private plan are covered for eligible drugs by OHIP+, which is worth understanding before you pay for a family drug tier. Our guide to health and dental insurance for families covers the details.

Self-employed or incorporated. Compare a plan against a Health Spending Account, or use both. Premiums for an individual plan are generally deductible for the self-employed within CRA limits, and an HSA reimburses eligible expenses with no per-category caps. See health and dental insurance for the self-employed and our Health Spending Account guide.

Retiree, 65 or older. The Ontario Drug Benefit covers eligible prescriptions from 65, so drug coverage in a private plan matters much less. Dental, vision, paramedical and travel emergency medical become the reasons to buy. Plans designed for retirees, and conversion plans for those leaving a group plan at retirement, are usually the right shortlist. See health and dental insurance for retirees.

Leaving a group plan. If anyone in the household has a condition, apply for a conversion plan within 60 days first, then compare regular plans in parallel. Our step-by-step guide on replacing group benefits when you leave a job sets out the deadlines.

Indicative monthly costs in Ontario

The ranges below are illustrative for 2026, for a mid-range (enhanced) tier with a modest deductible. They are not quotes. Age, tier, deductible, the number of people covered and the insurer all change the premium.

Who is covered	Indicative monthly premium, enhanced tier
Single adult under 40	roughly $70–$120
Single adult 40–64	roughly $90–$150
Couple	roughly $150–$260
Family (two adults, two or more children)	roughly $180–$350
Single adult 65+ (retiree plan)	roughly $90–$180

A more detailed breakdown by tier and age is in our article on private health insurance cost in Ontario.

Mistakes we see people make

• Buying on premium alone. The cheapest plan is cheap because it pays out the least. Match the tier to your expected use.
• Buying right before major dental work. Waiting periods exist for exactly this reason. Buy early, or plan to pay for that one procedure out of pocket.
• Ignoring the pre-existing condition wording. Guaranteed acceptance is not the same as guaranteed coverage of your existing condition.
• Missing the 60-day conversion window after leaving a group plan, then discovering a regular plan excludes a condition.
• Forgetting to check practitioner eligibility. A plan that covers “psychologists” may not cover the registered psychotherapist you already see.
• Not reviewing every couple of years. Insurers reprice, and your needs change. A quick re-quote can save a meaningful amount.

How Hayes can help

We’re an independent, family-run brokerage on Preston Street in Ottawa, licensed for all of Ontario, and we compare individual health and dental plans from Canada’s major insurers side by side. Tell us your prescriptions, your dental situation and who needs to be covered, and we’ll show you the two or three plans that genuinely fit, with the trade-offs spelled out. Our advice is free; the insurer pays us when you buy.

Want to see your options? Compare health and dental quotes from 30+ Canadian insurers in about two minutes, free and with no obligation. Or contact us and we’ll do it together.